Tag Archives: Αναστάσιος Λιάτας – Διευθυντής Χειρουργός ΕΣΥ

Multiple congenital internal hernias as a cause of acute abdominal symptoms in late adult life

10 Οκτωβρίου, 2012

Δεν επιτρέπεται σχολιασμός στο Multiple congenital internal hernias as a cause of acute abdominal symptoms in late adult life

Συντάχθηκε από:

Αναστάσιος Λιάτας, MD, F.I.C.A. – Διευθυντής Χειρουργός

A C Liatas, MD, F.I.C.A. – Consultant Surgeon

Athens  General  Hospital  » EVAGELISMOS «

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Abstract

Internal hernias rarely cause intestinal obstruction, the reported incidence being between 1 and 1.7 %. The most common sites of herniation are the epiploic foramen and the transverse mesocolon, and hernias through defects in the greater or lesser omentum are rare. An even rarer occurrence is the presence of two or three such hernias in the same patient.

Discussion

Internal hernias can occur in various places and they have distinctive clinical and radiological features. Among the most common types are: omental, Treizt’s, mesenteric, caecal, retrocaecal, intersigmoid, sliding, and uterine hernias. Internal hernias account for less than 2 % of the cases of obstruction caused by herniation but the incidence of asymptomatic internal hernias found at necropsy was reported to be between 0.2 % and 0.9 %. Of these only about 1-4% are omental hernias. Our case shows that the aetiology of such hernias, which has previously not been clarified, must be congenital.

Δημοσίευση Άρθρου

Το πλήρες άρθρο έχει δημοσιευθεί στο: [ Eur J Surg 1992; 158:561-562 ]

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Για το πλήρες άρθρο «Multiple congenital internal hernias…» πατήστε: Εδώ (.pdf αρχείο).

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Iatrogenic and noniatrogenic arterial trauma – a comparative study

15 Σεπτεμβρίου, 2012

Δεν επιτρέπεται σχολιασμός στο Iatrogenic and noniatrogenic arterial trauma – a comparative study

Συντάχθηκε από:

Αναστάσιος Λιάτας, MD, F.I.C.A. – Διευθυντής Χειρουργός

A C Liatas, MD, F.I.C.A. – Consultant Surgeon

Athens  General  Hospital  » EVAGELISMOS «

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Iatrogenic and Noniatrogenic Arterial Trauma

Introduction

Iatrogenic arterial trauma may arise in diagnostic or therapeutic  procedures   (Gr.   ἰατρός  =  physician, γεννώ = give birth to). The incidence of reported iatrogenic  arterial  trauma  has  clearly risen in recent years, as a result of the dramatically increased performance  of  cardiac  catheterization  and angiography, or of the increasingly  radical  operations now performed for a variety of lesions in all surgical fields.

Purpose of study

This study compared patients with iatrogenic and noniatrogenic arterial injuries.

Discussion

Although iatrogenic arterial trauma is a well defined clinical entity, its reported incidence in relation to total numbers of arterial injuries varies from 1.4% to 76% . In our study, 34% of the arterial injuries were iatrogenic. As some cases of iatrogenic arterial injury are not reported for fear of legal consequences, no clear picture of the problem’s size is obtainable.
The arteries of the extremities most often affected were brachial and femoral, the commonest sites of arterial puncture in the iatrogenic group, and leg arteries were mostly injured in noniatrogenic group. Orthopaedic and general surgery were responsible for most iatrogenic injuries. Haemorrhage, presenting either as an arterial bleed or as an expanding haematoma, occurred in 28 of our 43 non iatrogenic arterial injuries, but in only four of the 22 in the iatrogenic group (p < 0.001). The patients in that group presented mainly with severe or mild ischaemia.
The postoperative mortality rate did not differ significantly between iatrogenic and noniatrogenic group, which accords with previously reported corresponding rates of 10% and 15 % . Other authors found 4 %  or 1.7%  mortality in their series of iatrogenic vascular injury, compared with 14 % in our series.
Factors of two types have been implicated in iatrogenic vascular injury, viz. doctor-related (inadequate knowledge, inefficient anatomic dissection or traumatic or faulty technique) and patient-related (inflammation, tumour, irradiation, reoperation, anatomic variations). Most of them are related to arterial catheterization performed mainly by nonsurgeons.

Conclusion

As iatrogenic arterial injuries may occur even in the most capable hands, they must be recognized and adequately corrected so as to reduce the risk of incapacitating sequelae.

Δημοσίευση του Άρθρου

Το πλήρες άρθρο έχει δημοσιευτεί στο: [ Eur J Surg 1991; 157:17-20 ]

Αρχείου του Άρθρου

Για το πλήρες άρθρο «Iatrogenic and Noniatrogenic Arterial Trauma: a comparative study» πατήστε: Εδώ  (.pdf αρχείο).
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Η χειρουργική θεραπεία των ανευρυσμάτων της κοιλιακής αορτής σε υπερήλικες

14 Ιουνίου, 2012

Δεν επιτρέπεται σχολιασμός στο Η χειρουργική θεραπεία των ανευρυσμάτων της κοιλιακής αορτής σε υπερήλικες

Συντάχθηκε από:

Αναστάσιος Λιάτας, MD, F.I.C.A. – Διευθυντής Χειρουργός

A C Liatas, MD, F.I.C.A. – Consultant Surgeon

Athens  General  Hospital  » EVAGELISMOS «

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Σύνοψη Άρθρου

Σκοπός αυτής της μελέτης είναι η ανάλυση όλων των περιπτώσεων Ανευρυσμάτων Κοιλιακής Αορτής (Α.Κ.Α) που χειρουργήθηκαν εκλεκτικά ή επειγόντως στο Αγγειοχειρουργικό Τμήμα του Νοσοκομείου μας κατά την τελευταία 10ετία με ιδιαίτερη έμφαση στους ασθενείς ηλικίας >75 ετών που χειρουργήθηκαν για Α.Κ.Α οξέως ή εκλεκτικά. Διαπιστούται στατιστικά σημαντική διαφορά στη θνητότητα μετά από εγχείρηση για ρήξη Α.Κ.Α μεταξύ υπερηλίκων (>75 ετών) και ασθενών ηλικίας (<75 ετών) που έχουν καλό προσδόκιμο επιβίωσης.

Abstract

«Surgical Treatment of Abdominal Aortic Aneurysms in the Elderly»

An increasingly growing incidence of abdominal aortic aneurysms has been observed in recent years resulting from the increase of life expectancy. Therefore aneurysmatectomy has become one of the most frequently performed operations in vascular surgery. From 1985 to 1989 seventy nine cases of abdominal aortic aneurysms were operated upon in the Department of Vascular Surgery of Athens General Hospital. 41 were elective whereas 38 were due to a ruptured abdominal aortic aneurysm. Group A (28 cases) included patients > 75 years of age (mean age = 79 years) and Group B (51 cases) comprised of patients <75 years of age (mean age = 67.3 years). There was a statistically significant difference in the mortality rate in the operated patients of groups A and B following rupture of their aneurysm whereas there was not such a difference among the patients of both groups when they had operated their aneurysm electively. Therefore elective surgery of abdominal aortic aneurysm should be undertaken in the elderly when life expectancy is anticipated to warrant the risks of the almost inevitable rupture of such an aneurysm.

Δημοσίευση Άρθρου

Το πλήρες άρθρο έχει δημοσιευτεί στο: [ Ιατρικά Χρονικά, Τόμος ΙΓ, Τεύχος 4, Σελ. 357-360 ]

Αρχείο Άρθρου

Για το πλήρες άρθρο «Η Χειρουργική Θεραπεία των Ανευρυσμάτων…» πατήστε:  Εδώ (.pdf αρχείο).

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